Posted by Mitch on August 15, 2001, at 0:27:43
In reply to Bipolar meds/anxiety-follow up from anxious mom, posted by cb on August 14, 2001, at 18:07:03
> My bipolar son has been very anxious and depressed. Dr has taken him off synthroid, neurontin, and klonopin. He is currently on lithobid (1200 mg) and zyprexa (10 mg) and Wellbutrin (400 mg). Previously he was on zoloft, paxil and celexa while taking depakote. His doctor is considering putting him back on an SSRI and upping his lithium. SSRIs have always made him manic before (while on the Depakote). Does anyone have experience with the SSRIs and lithium. I think someone who answered me before mentioned taking prozac and a mood stabilizer after having gotten manic from the SSRI? I would really appreciate input. We are a little nervous about the SSRI since the SSRI manias were aggressive and violent. Unfortunately, they seem to have been the only thing that has helped the depression. Thank you, thank you, thank you - anxious mom
AnxMom,
So, given the lithium, Wellbutrin, and Zyprexa your son is still showing mixed anxiety and depression but the manic symptoms are currently being controlled, right? Given the prominent anxiety he has displayed and sensitivity to SSri's I would wonder if the Wellbutrin dosage may be much too high (he could be experiencing primary anxiety/agitation that is feeding the depression).
First, I would consider dropping down the Wellbutrin and see if his anxiety falls off and given the reduction of anxiety his mood *improves*. I mean, you haven't seen him depressed without being anxious and agitated, correct?
Another thing to consider after that, would be the possibility that the Zyprexa could be causing agitation as well.
I wouldn't be surprised if he could be on lithium+ a low-dose of Remeron or Serzone (something somewhat sedative and anxiolytic) and respond quite well.
Mitch
poster:Mitch
thread:75085
URL: http://www.dr-bob.org/babble/20010814/msgs/75112.html